目的 在急性冠脉综合征（ACS）患者中开展替格瑞洛的药物基因组学研究，以期发现能预测替格瑞洛出血不良反应个体差异的遗传学因素。方法 对中国人民解放军联勤保障部队第九〇〇医院2018年收治的75例本地区汉族符合入排标准的 ACS患者，进行 SLCO1B1、UGT2B7、P2Y12、PEAR1、ITGA2B、ITGB3的单核苷酸多态性检测，同时收集并记录患者的性别、年龄、体质量指数（BMI）、合并症、患病类型、吸烟状况、饮酒状况、生化指标以及最大血小板聚集率及出血事件。通过二元 Logistic回归分析法分析替格瑞洛出血不良反应与基因多态性的相关性。结果 二元 Logistic回归分析结果表明，SLCO1B1 rs4149056、PEAR1 rs12407843、PEAR1 rs77235035与替格瑞洛出血风险显著相关，而调整混杂因素后的分析结果显示上述基因型与替格瑞洛出血不良反应没有显著相关性，均不能作为预测替格瑞洛出血不良反应的独立遗传因素（P＞0.05）。结论 未发现替格瑞洛转运受体、作用靶点以及血小板膜受体相关的基因单核苷酸多态性与替格瑞洛导致的出血不良反应有显著相关性。

Objective To develop a pharmacogenomics study of ticagrelor in patients with acute coronary syndrome (ACS) to identify the genetic factors that can predict individual differences in adverse reactions of ticagrelor hemorrhage. Methods 75 ACS patients of Chinese Han in The 900th Hospital of Joint Logistics Support Force of Chinese PLA in 2018 who met the entry criteria were recruited. The patient was tested for the single nucleotide polymorphisms of SLCO1B1、 UGT2B7、 P2Y12、 PEAR1、 ITGA2B、ITGB3. Gender, age, BMI, complication, disease type, smoking status, drinking status, biochemical index and adverse reactions of hemorrhage of patient were collected and recorded. The correlation between adverse reactions of ticagrelor hemorrhage and gene polymorphism was analyzed by Binary Logistic Regression. Results The results of Binary Logistic Regression analysis showed that SLCO1B1 rs4149056、 PEAR1 rs12407843 and PEAR1 rs77235035 were significantly correlated with the risk of ticagrelor hemorrhage, while the results of adjusted confounding factors showed that the above genotypes were not significantly correlated with the adverse reactions of ticagrelor hemorrhage, and could not be used as independent genetic factors to predict the adverse reactions of ticagrelor hemorrhage (P＞0.05). Conclusion There was no significant correlation between single nucleotide polymorphisms of genes associated with ticagrelor transporters, targets, and platelet membrane receptors and adverse reactions of hemorrhage caused by ticagrelor.

R971

中国人民解放军联勤保障部队第九〇〇医院课题-军民融合临床研究专项（2018J03）